Document Detail


Long-term neuropathy after oxaliplatin treatment: challenging the dictum of reversibility.
MedLine Citation:
PMID:  21478275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Oxaliplatin-induced neuropathy is a significant and dose-limiting toxicity that adversely affects quality of life. However, the long-term neurological sequelae have not been adequately described. The present study aimed to describe the natural history of oxaliplatin-induced neuropathy, using subjective and objective assessments.
METHODS: From a population of 108 oxaliplatin-treated patients referred for neurological assessment in 2002-2008, 52.2% of the surviving patient cohort (n = 24) was available for follow-up at a median of 25 months post-oxaliplatin. Patients underwent a protocol that incorporated clinical assessment scales, patient questionnaires, standard electrodiagnostic assessments, and novel nerve excitability studies to precisely assess nerve function.
RESULTS: At follow-up, 79.2% of patients reported residual neuropathic symptoms, with distal loss of pin-prick sensibility in 58.3% of patients and loss of vibration sensibility in 83.3% of patients. Symptom severity scores were significantly correlated with cumulative dose. There was no recovery of sensory action potential amplitudes in upper and lower limbs, consistent with persistent axonal sensory neuropathy. Sensory excitability parameters had not returned to baseline levels, suggesting persisting abnormalities in nerve function. The extent of excitability abnormalities during treatment was significantly correlated with clinical outcomes at follow-up.
CONCLUSIONS: These findings establish the persistence of subjective and objective deficits in oxaliplatin-treated patients post-oxaliplatin, suggesting that sensory neuropathy is a long-term outcome, thereby challenging the literature on the reversibility of oxaliplatin-induced neuropathy.
Authors:
Susanna B Park; Cindy S Y Lin; Arun V Krishnan; David Goldstein; Michael L Friedlander; Matthew C Kiernan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-08
Journal Detail:
Title:  The oncologist     Volume:  16     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-09-13     Revised Date:  2012-05-01    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  708-16     Citation Subset:  IM    
Affiliation:
Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / adverse effects*,  therapeutic use
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Deoxycytidine / adverse effects,  analogs & derivatives,  therapeutic use
Female
Fluorouracil / adverse effects,  analogs & derivatives,  therapeutic use
Humans
Male
Middle Aged
Neurotoxicity Syndromes / diagnosis,  epidemiology*,  etiology*
Organoplatinum Compounds / adverse effects*,  therapeutic use
Questionnaires
Sensation Disorders / chemically induced*,  diagnosis,  epidemiology*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Organoplatinum Compounds; 51-21-8/Fluorouracil; 63121-00-6/oxaliplatin; 951-77-9/Deoxycytidine

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